The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATM) was formed in response to the needs of the unabated domestic HIV epidemic in youth. The Adolescent Medicine Leadership Group (AMLG) and ATM Coordinating Center (ACC) described in this application propose to continue to build on their scientific, administrative and experiential leadership in the ATM and together with the site personnel develop and implement the scientific agenda of the ATN for this next project period. The scientific and administrative leadership proposed here will continue to work toward maximizing quality, efficiency and productivity while incorporating responsiveness, flexibility, transparency and innovation in their work. Additionally, the ATN as a whole will continue to nurture and expand the collaborations that were established in the first project period with other federally funded networks and programs. The proposed ACC will continue its pivotal facilitating role in the functioning of the ATN. The AMLG is proposed to initiate this project period with three distinct scientific leadership groups, the Behavioral (BLG), Community Prevention (CPLG) and Therapeutic Leadership Groups (TLG), with complimentary expertise both within and across groups to provide the multidisciplinary approach needed to address issues in the populations of focus. The BLG will focus its agenda on both perinatally and behaviorally HIV infected youth and have identifed the following key areas for interventions: mental health, secondary prevention and risk reduction, needs of youth engaging in care including those acutely infected, and medication adherence. The CPLG will focus on continued development of a community based primary prevention infrastructure and interventions including biological interventions such as vaccines or microbicides. The agenda of the TLG uses a theoretical framework to identify key elements and approaches for an adolescent specific agenda for both perinatally and behaviorally infected youth. The scientific agenda of the leadership groups will be continually reviewed in the context of future developments and a flexible, adaptive approach to address new needs will continue to be a priority. The ATN as a whole remains the only federally funded network focused solely on the complex needs and issues of the HIV infected and at-risk youth at the epicenter of the domestic HIV epidemic.